JMIR Publications

ABSTRACT

Background:

Youth experiencing homelessness and housing instability evidence disparities in tobacco use and co-use of tobacco and cannabis products compared to their stably-housed peers. Interventions to address these disparities have had limited success to-date. This may be related to a lack of fit between intervention approaches and the unique needs and preferences of this marginalized population. Leveraging strategies to facilitate authentic engagement of youth in intervention research, including collaborating with youth in the co-creation of intervention goals and strategies, present an opportunity to overcome challenges of prior research to mitigate tobacco-related disparities among youth experiencing homelessness and housing instability.

Objective:

This paper presents a protocol to engage youth collaborators in intervention research to address tobacco-related disparities among youth experiencing homelessness and housing instability. The protocol outlines strategies to (1) recruit and partner with youth to co-create a strengths-based, expressive arts intervention to reduce harms associated with tobacco and tobacco and cannabis co-use, and (2) evaluate our youth engagement strategies.

Methods:

The community and academic partner leading this intervention study developed a structure which allows for two levels of youth collaboration. This structure, developed through consultation with a youth action board, facilitates youth (ages 14-26) involvement in intervention design, implementation, and pilot testing. At the higher collaboration level, youth will join the intervention research team as “Co-researchers,” engaging weekly with study-related tasks and contributing equitably to research processes (e.g., selecting intervention strategies; supporting data analysis) as aligned with their personal and professional goals. At the lower collaboration level, youth will engage with the research team as “Advisors,” providing targeted feedback at key points during intervention development. Brief surveys, field notes and ethnographic memos, and semi-structured interviews will evaluate our process and impact among youth engaged.

Results:

To-date, we have engaged n=7 Co-researchers who have participated in several capacity-building and professional development activities, including research ethics training and tobacco prevention advocacy training. Co-researchers have contributed to intervention development brainstorming sessions, evaluated available interventions to address youth tobacco use, and developed materials to expand the group of Co-researchers and Advisors. Preliminary data suggest sufficient youth engagement (study goal of engaging n=10 co-researchers in a 2-year study period) and that engagement processes are highly acceptable to youth collaborators. Lessons learned to-date have helped us to improve and refine our engagement processes (e.g., technological barriers).

Conclusions:

This protocol describes a holistic approach to equitably and authentically engaging youth as collaborators in intervention research to address tobacco-related disparities among youth experiencing homelessness and housing instability. The approach may serve as a useful model that can be adapted for other youth-focused intervention research.